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Dysphagia Dr. Meg-angela Christi Amores. Dysphagia a sensation of "sticking" or obstruction of the passage of food through the mouth, pharynx, or esophagus.

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Presentation on theme: "Dysphagia Dr. Meg-angela Christi Amores. Dysphagia a sensation of "sticking" or obstruction of the passage of food through the mouth, pharynx, or esophagus."— Presentation transcript:

1 Dysphagia Dr. Meg-angela Christi Amores

2 Dysphagia a sensation of "sticking" or obstruction of the passage of food through the mouth, pharynx, or esophagus often used as an umbrella term to include other symptoms related to swallowing difficulty

3 Definition of terms Aphagia – signifies complete esophageal obstruction Odynophagia – painful swallowing Globus pharyngeus – is the sensation of a lump lodged in the throat Phagophobia – meaning fear of swallowing

4 Physiology of Swallowing

5 Pathophysiology of Dysphagia oral, pharyngeal, and esophageal mechanical dysphagia - caused by a large bolus or a narrow lumen is called motor dysphagia - due to weakness of peristaltic contractions or to impaired deglutitive inhibition causing nonperistaltic contractions and impaired sphincter relaxation

6 Oral phase dysphagia associated with poor bolus formation and control food may either drool out of the mouth or overstay in the mouth patient may experience difficulty in initiating the swallowing reflex premature spillage of food into the pharynx and aspiration into the unguarded larynx and/or nasal cavity

7 Pharyngeal phase Dysphagia associated with stasis of food in the pharynx due to poor pharyngeal propulsion and obstruction at the UES leads to nasal regurgitation and laryngeal aspiration during or after a swallow Nasal regurgitation and laryngeal aspiration during the process of swallowing are hallmarks

8 Esophageal Dysphagia the esophageal lumen can distend up to 4 cm – When the esophagus cannot dilate beyond 2.5 cm in diameter, dysphagia to normal solid food can occur – when the esophagus can’t distend beyond 1.3 cm, dysphagia ALWAYS occurs

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10 History can provide a presumptive diagnosis in >80% of patients Nasal regurgitation and tracheobronchial aspiration with swallowing are hallmarks of pharyngeal paralysis or a tracheoesophageal fistula Hoarseness – precedes dysphagia, the primary lesion is usually in the larynx – following dysphagia may suggest involvement of the recurrent laryngeal nerve

11 History Type of food – Difficulty only with solids implies mechanical dysphagia with a lumen that is not severely narrowed – dysphagia occurs with liquids as well as solids in advanced obstruction Duration – Transient dysphagia may be due to an inflammatory process – Progressive, lasting days to weeks - carcinoma


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